There are no new names in our Top 20 Pharma ranks, but mega-mergers and patent expirations have re-shaped the upper end the list this year. Pfizer stayed on top for another year (although it may choose to abdicate), but Novartis creeped up from #3 to #2, boosted by its Alcon revenues, and Merck jumped from #6 to #3 after integrating Schering-Plough’s sales. Sanofi and GlaxoSmithKline, meanwhile, both fell behind as their annual sales dropped from 2009. (Good thing Sanofi will be able to add in some Genzyme revenues next year!)

Pharma is in the midst of some tumultuous times. I foresee a lot more jockeying for position in the next several years.